Angelos M G, Leasure J E, Barton R L
Department of Emergency Medicine, Wright State University, Cox Institute, Kettering, Ohio.
Ann Emerg Med. 1993 Feb;22(2):171-7. doi: 10.1016/s0196-0644(05)80197-0.
Fructose-1,6-diphosphate (FDP) appears to improve early post-myocardial infarction hemodynamics and limit early myocardial infarct size in previous canine studies. However, these studies did not account for the effect of collateral blood flow on infarct size. Our objective was to determine the effect of FDP on early infarct size and hemodynamics while measuring regional myocardial blood flow.
A prospective, blinded, placebo-controlled laboratory study using a canine open-chest left anterior descending coronary artery (LAD) occlusion model.
Twenty-two mongrel dogs were assigned randomly to receive either FDP (175 mg/kg, then 2 mg/kg/min for two hours) or placebo, beginning five minutes after LAD occlusion.
Regional myocardial blood flow, hemodynamics, and myocardial infarct size were determined. Infarct size was assessed using magnetic resonance imaging in a subset of animals. Three of the 22 dogs had no infarct and significantly higher collateral blood flow than the 19 animals with myocardial infarction (P < .001). Four hours after LAD occlusion, cardiac index, dP/dtmax, heart rate, and systolic and mean aortic pressures were not statistically different between groups. Infarct size expressed as area of necrosis/area at risk was similar between groups (FDP, 0.55 +/- 0.28; controls, 0.59 +/- 0.31).
FDP given after occlusion of the LAD in this canine model did not limit early myocardial infarct size.
在先前的犬类研究中，1,6-二磷酸果糖（FDP）似乎可改善心肌梗死后早期的血流动力学，并限制早期心肌梗死面积。然而，这些研究并未考虑侧支血流对梗死面积的影响。我们的目的是在测量局部心肌血流的同时，确定FDP对早期梗死面积和血流动力学的影响。
一项前瞻性、双盲、安慰剂对照的实验室研究，采用犬类开胸左前降支冠状动脉（LAD）闭塞模型。
22只杂种犬在LAD闭塞后5分钟开始随机接受FDP（175mg/kg，然后以2mg/kg/min持续输注2小时）或安慰剂。
测定局部心肌血流、血流动力学和心肌梗死面积。在一部分动物中使用磁共振成像评估梗死面积。22只犬中有3只无梗死，其侧支血流明显高于19只有心肌梗死的动物（P<.001）。LAD闭塞4小时后，两组间的心指数、dP/dtmax、心率以及收缩压和平均主动脉压无统计学差异。以坏死面积/危险面积表示的梗死面积在两组间相似（FDP组为0.55±0.28；对照组为0.59±0.31）。
在此犬类模型中，LAD闭塞后给予FDP并不能限制早期心肌梗死面积。
